摘要
目的探讨脓毒症患者新发房颤的发病率及其危险因素。方法收集2016年7月至2019年7月中南大学湘雅三医院重症医学科收治的455例脓毒症患者的临床资料,根据住院期间是否发生新发房颤分为脓毒症新发房颤组(New onset atrial fibrillation,NOAF组)和未发房颤组。收集研究对象的一般资料、实验室指标、住ICU时间和28d死亡率,对比两组间有无统计学差异。结果223例患者纳入本研究,其中未发房颤组190例和NOAF组33例。NOAF组患者年龄、APACHEⅡ评分、发生脓毒性休克的比例大于未发房颤组,差别有统计学意义(P<0.05)。NOAF组24h内平均心率及乳酸值大于未发房颤组;而血钾明显低于未发房颤组,差异具有统计学意义(P<0.05)。Logistic回归分析结果提示年龄、脓毒性休克、心血管病史、心率增快(心率110次/min)和低血钾(血钾<3.5mmol/L)是脓毒症患者新发房颤的独立危险因素,差异具有统计学意义(P<0.05)。结论高龄、有心血管疾病病史、休克、心率增快(心率110次/min)和低血钾(血钾<3.5mmol/L)是脓毒症患者新发房颤的独立危险因素。
Objective To determine risk factors of new onset atrial fibrillation in patients with sepsis.Methods Patients,admitted to intensive care units and diagnosed as sepsis,were recruited to our study from July 2016 to July 2019 in the third Xiangya Hospital,Central South University.According to whether onset atrial fibrillation occurred during hospitalization,the patients were divided into two groups:NOAF group and non-AF group.The general data,laboratory indexes,ICU stay time and 28 day mortality rate were collected in the research.Results Among 223 enrolled patients,33 were assigned to NOAF group while 190 were non-AF group.The NOAF group had a significantly higher age,APACHEⅡscores,as well as the incidence of septic shock(P<0.05).The mean heart rate and lactate value in 24 hours in NOAF group were higher than that in non-AF group,while the blood potassium was significantly lower than that in non-AF group(P<0.05).The Logistic regression analysis showed that age,septic shock,cardiovascular history,increases in heart rate(HR>110 bpm)and blood potassium<3.5 mmol/L were independent risk factors of NOAF in septic patients.Conclusions Advanced age,history of cardiovascular disease,shock,increases in heart rate(HR>110 bpm),as well as blood potassium<3.5 mmol/L were independent risk factors of NOAF in septic patients.
作者
罗文治
高敏
刘晶晶
颜姗珊
Luo Wenzhi;Gao Min;LiuJingjing;Yan Shanshan(Cardiology Department,Third Xiangya Hospital,Central South University;Department of Critical Care Medcine,Third Xiangya Hospital,Central South University,Changsha,China)
